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Freedom to practise: dispelling the myths launched

The Department of Health and the Royal College of Nursing have published Freedom to practise: dispelling the myths, a resource to help staff find the best solutions to overcome the myths and obstacles that often hold them back from providing efficient patient care.

Freedom to practise: dispelling the myths will help frontline staff clarify what they are allowed to do within their Codes of Practice, providing practical factsheets about the legal and professional frameworks that support them. The RCN Faculty of Emergency Nursing provides a framework of measurable clinical competencies enabling nurses to maximise their skills and move through a career pathway. A system of education and training is essential to ensure health care professionals have the knowledge, skills and competencies they need.

Jonathan Asbridge, clinical director for patient experience in A&E, said: "The approach outlined in this publication offers a systematic framework to help teams to recognise new ways of providing improved care and will be welcomed by patients and clinical teams alike."

We hope that this booklet will be useful for all staff in helping to continue to change practice and to challenge the myths that hold back frontline practitioners. The publication can be found at www.doh.gov.uk/emergencycare/freedomtopractice.pdf

For further information please contact Julie Pearce on 020 7972 4582 or at Julie.pearce@doh.gsi.gov.uk

Hutton announces further £28 million boost for out-of-hours care

Health minister John Hutton has announced an extra £28 million over the next two years to help local areas develop high quality out-of-hours (OOH) health services. This will include a technical infrastructure that will connect all OOH health providers to NHS Direct.

John Hutton said: "All of us want to know that if our child or parent is ill during the night there will be a health professional immediately available to provide the care they need. The challenge of providing out-of-hours care is therefore one that affects all of us. The Department of Health is determined to support local health providers in meeting this challenge. The resources and expertise are there and a lot of good work is already underway."

Further information at www.out-of-hours.info or contact John Taylor on 0113 254 5704 or at John.Taylor@doh.gsi.gov.uk

£6 million National Lottery funding for community defibrillators

An injection of £6 million in National Lottery funding from the New Opportunities Fund will enable the British Heart Foundation to deliver help for people across England who suffer a heart attack in the community.

The money will be used to buy 2,300 defibrillators and training equipment. Defibrillators will be deployed in places where people most at risk of cardiac arrest will benefit such as shopping centres and bus stations. This should reduce any delay between the point at which a patient collapses and treatment is provided. The funding will also pay for a community defibrillator officer at each trust and will increase the number of people trained to use the equipment and trained in the vital skills of emergency life support.

New Opportunities Fund chair Baroness Jill Pitkeathley said: "It is vital that people suffering cardiac arrest receive treatment as soon as possible and this investment of defibrillators in the community could make the difference between life and death. Research reveals that having defibrillators close by will increase people’s chance of survival from sudden cardiac arrest when out and about by nine-fold."

For more information please contact Helen Eldridge in the BHF press office on 0207 487 7172 or e-mail pressoffice@bhf.org.uk

Case Study

Volunteers at King’s Mill Hospital

Following a successful trial, King's Mill Hospital in Sutton-in-Ashfield, Nottinghamshire, has introduced 25 volunteers in their A&E department. They help in various ways including keeping patients company, making refreshments and administration.

Feedback from both the public and staff has been very positive as both feel better informed and that a higher quality of care is being given. Volunteers are an important aspect of improving the patient experience, helping to build relationships and to help staff understand patients’ views about the service. As one patient told us: "The person you see should be more caring and know how to deal with people."

Volunteers can also help maintain a clean and comfortable environment, which can make a huge difference to patients’ perception of the NHS and staff working conditions.

Lyn Norris, voluntary services organiser from King's Mill, said: "The volunteers keep the patient and their relatives and carers more informed and comfortable and maintain a vital link with staff. This has enhanced the patients' experience and increased satisfaction with the service."

For further information please contact Lyn Norris, voluntary services organiser, on 01623 676011or at lyn.norris@sfh-tr.nhs.uk

Voicepiece

Health minister Rosie Winterton thanks emergency care staff for their commitment and hard work and looks forward to the challenges ahead in 2004

2003 was a big year for emergency care in England. Thanks to the commitment and hard work of frontline staff, the service for A&E patients is being transformed into something genuinely world class. Much has been achieved – every acute trust in the country is participating in the emergency services collaborative; the first champion for A&E patient experience, Jonathan Asbridge, started work; the Choice, Responsiveness and Equity consultation exercise has started to look at the fundamental questions of how patients perceive and get access to urgent health care and we are ending the year with a mature and rational debate about what the four-hour standard means and how it should be applied in patients’ best interests.

I want to record my thanks for what you and your colleagues have achieved. Since I moved to the Department of Health I have taken every opportunity to see NHS services in action and, wherever I’ve been, I’ve seen something that has impressed me. We need to maintain the momentum as 2004 will be a bigger year still and will take the transformation process even further. What we do in terms of patient experience (including their total time in A&E) and the debate that Sir George Alberti will lead on – the next steps for emergency care – will shape services for a long time to come. You will all play a part in that and I’m looking forward to working with you for another year.

To send your comments and feedback to the health minister e-mail emergencycare@doh.gsi.gov.uk

NEWS IN BRIEF

Domestic violence initiative

A busy A&E department will see many victims with injuries as a result of domestic violence. Sheer volume of work and the fact that the patient is often accompanied can make it difficult to raise the issue. A simple initiative launched at King’s Mill Hospital helps ensure patients can take the opportunity to receive information they may need, if they visit the A&E department.

To avoid increasing risk or stigmatising individuals, posters have been put up stating the prevalence of domestic abuse. One in four women and one in six men will be a victim of domestic violence in their lifetime. They also state related health risks and alert patients to the fact that all female patients will be given an information card with useful contact numbers and tips. Evidence says victims experience on average 35 episodes of domestic violence before seeking help and a card can easily be kept until they are ready to use it. Staff also attended training which included information on managing domestic violence, associated safety aspects and the need to record injuries accurately.

For further information please contact Christine Mann on 01623 784339 or e-mail Christine.Mann@mansfield-pct.nhs.uk

Calling Time bulletin

The new edition of the Calling Time bulletin is now available at www.modern.nhs.uk/workingtime/bulletin

This is a monthly update on how the NHS is meeting the challenge of achieving the requirements of the Working Time Directive for junior doctors. It is aimed at sharing knowledge, findings and resources being developed at the WTD pilot sites across England.

Hard copies can be ordered from sarah.parson@doh.gsi.gov.uk

For further information contact Gary Sutter, communications officer, on 020 7210 5852 or at HRDtemp5@doh.gsi.gov.uk

Emergency care multilingual phrasebook pilot

The Department of Health is producing a multilingual phrase book for A&E staff as part of the programme of work to improve the patient experience. This is to help them communicate with patients whose first language is not English. The phrasebook is being produced in conjunction with the British Red Cross and is currently being piloted in Barts and the London, Birmingham Heartlands and Bradford Teaching Hospital. It will form part of a wider toolkit to help improve information for patients in A&E which will be launched in the new year. For further information e-mail emergencycare@doh.gov.uk

Emergency Services Collaborative update

Almost one million people were cared for within four hours in A&E departments across England in September 2003, compared to about 698,000 people in September 2002. That means that about 260,000 A&E patients received better care quicker, partially due to innovations and changes made during the Emergency Services Collaborative (ESC) programme.

Many sites have found that an effective way to care for patients more quickly and effectively is to augment the skill sets of existing A&E staff, as featured in the September national report. Training up staff has provided two distinct benefits:

• it provides patients with quality, experienced care in a more timely manner

• it has boosted morale; staff are now more empowered to meet patient needs and feel that management is taking an active interest in their career development.

Andie Howard, ESC programme manager at Guy’s & St. Thomas’ Hospital, which expanded senior nurse roles with Advanced Assessment Skills, said: "Morale improved because the ENPs provide the whole patient care from arrival to discharge – the patients liked this and it is satisfying for the nurses. Waiting times also fell, which improved patient satisfaction and reduced incidences of patient aggression."

For further information on the ESC, its events and monthly report, contact Kerrin Howard at 020 7061 6780 or via e-mail at Kerrin.Howard@doh.gsi.gov.uk or visit www.modern.nhs.uk/emergency.

Recent additions to the electronic library and toolkit

A summary of recent additions to the National Electronic Library for the Department of Health’s emergency care specialist library is available at
www.nelh-ec.warwick.ac.uk/

Recent additions to the emergency care toolkit are available at www.nelh-ec.warwick.ac.uk/ECL_Toolkit/index.html

Events

National ambulance conference and learning days – 11 and 12 November 2003

As part of the Improvement Partnership for Ambulance Services (IPAS) announced by Rosie Winterton in September, two national ‘Learning Exchanges’, involving ambulance trusts, PCTs, acute trusts and SHAs were held on 11 and 12 November 2003 in Manchester and London respectively.

The events, organised to spread good practice within the ambulance service and to raise awareness of the work ambulance trusts can do within the wider health community, were a great success. Each prompted thoughtful discussion and suggested positive next steps through a mixture of plenary sessions and workshops.

For further information on the work of IPAS, please go to www.modern.nhs.uk/ambulance or contact Julia Taylor on 07876 506 593 or e-mail julia.taylor@doh.gsi.gov.uk

Emergency Care Leads Conference – 2 December 2003

The Emergency Care Leads conference was held at the Congress Centre, 28 Great Russell Street, London WC1. This event brought together emergency care staff in order to reflect on achievements in the last 12 months as well as the challenges that still face us in the future. Professor Sir George Alberti, national director for emergency access, chaired the conference and all delegates were able to attend workshops and hear keynote addresses.

Summaries of the key speeches will soon be available at www.doh.gov.uk/conferences

For further information please contact MCI UK on 01730 715200 at emergencycareleads@mci-group.com

Beyond the targets: delivering modern emergency care – 16 January 2004

The NHS Confederation is holding a one-day conference and exhibition at the Royal College of Physicians, London, supported by the Department of Health.

Beyond the targets: delivering modern emergency care’will look at the issues surrounding the delivery of emergency services and the implications for all involved. It will focus on the latest thinking on how we can make real improvements to the way accident and emergency services are managed and how these can be integrated into the wider NHS. It will be an opportunity for delegates to learn from their colleagues and share examples of best practice from throughout the country. Speakers already confirmed include health minister Rosie Winterton.

For further information or to register contact Jo Braithwaite, NHS Confederation, on 020 7959 7260 or at Josephine.braithwaite@nhsconfed.org

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